Individual
LAURA RILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4422 3RD AVE, BRONX, NY 10457-2545
(516) 672-2684
Mailing address
506 LENOX AVE, NEW YORK, NY 10037-1802
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
304702
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/24/2016
Last updated
10/28/2020
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